Urinary Incontinence and Urinary Tract Infections

Urinary incontinence and sabulous cystitis in mares: report of five cases

This report describes five cases of urinary incontinence in Quarter Horse mares associated with the development of sabulous cystitis. The animals in this study had a history of persistent urinary incontinence for eight months, with clinical signs of continuous dribbling urine during rest and movement. The initial treatment with antibiotics and anti-inflammatory drugs was ineffective. Clinical examination revealed severe scalding in the perineal region and on the medial aspect of the hind limbs, along with neurological signs such as ataxia, hind limb paresis, and diminished perineal reflexes. Transrectal ultrasonography confirmed bladder distension and the presence of hyperechoic particles in the urine. Urinalysis revealed typical features of sabulous cystitis, including abundant calcium carbonate crystals. Despite treatment with corticosteroids, antibiotics, and daily bladder lavage with physiological saline, no substantial clinical improvement was observed. The limited therapeutic response and guarded prognosis were discussed with the owner, who opted to monitor the mares without altering their clinical condition for two years. This report highlights the complexity of managing urinary incontinence associated with sabulous cystitis in horses and emphasizes the importance of accurate diagnosis and early recognition of clinical signs for effective treatment.

Medical management and positive outcome after prolonged recumbency in a case of equine herpesvirus myeloencephalopathy

A 17-year-old mare presenting with acute fever, weakness and bladder dysfunction was diagnosed with equine herpesvirus myeloencephalopathy (EHM). The mare become transiently recumbent, underwent parenteral fluid therapy, plasma infusion, steroidal/nonsteroidal anti-inflammatory drugs (SAID/NSAIDs) and bladder catheterization. After 10 days the mare was hospitalized. Neurological evaluation revealed ataxia and proprioceptive deficits mainly in the hind limbs. The mare was able to stand but unable to rise from recumbency or walk. Secondary complications included Escherichia coli cystitis, corneal ulcers and pressure sores. A full-body support sling was used for 21 days. Medical treatment included systemic antimicrobials, NSAIDs, gradual discontinuation of SAIDs, parenteral fluid therapy and bladder lavage. The mare tested positive for Varicellovirus equidalpha 1 (EHV-1) DNA in nasal swab and blood samples on day 13 and in urine samples on days 13 and 25 after the onset of fever. Neurological signs improved over a period of 34 days and the mare was discharged with mild hind limb weakness/ataxia. Secondary complications resolved within 2 weeks. At the eight-month follow-up, marked improvement in locomotory function had been achieved.